Journal of the International AIDS Society · 2026
Integrating HIV Into Sexual and Reproductive Health Services for Female Sex Workers in Buenos Aires, Argentina: A Comprehensive Model Designed Through Intersectional Collaboration.
СтатьяНазвание и аннотация: Перевод в очереди
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Sandoval María Macarena, Aristegui Inés, Zalazar Virginia, Vulcano Silvina, Iannantuono María Victoria, Argüello Agustina, Frontini Emilia, Zeltman Ana C, Nava Agustín, Cardozo Nadir F, Romero Marcela, Orellano Georgina, Pérez Carolina F, Figueroa María Inés, Durán Adriana, Walmsley Sharon, Fink Valeria, “MAS por Nosotras” study team
Аннотация
INTRODUCTION: Female sex workers (FSWs) are at higher risk of sexually transmitted infections (STIs), including HIV, due to occupation-related factors further exacerbated by gender-specific vulnerability and marginalization. Stigma and fear of disclosing their occupation pose multiple barriers that limit access to sexual and reproductive health (SRH) services, as well as HIV testing, prevention and treatment. We describe the implementation of a tailored comprehensive SRH-HIV prevention and care model for FSWs, and report HIV prevalence, pre-exposure prophylaxis (PrEP) uptake and HIV treatment outcomes in our cohort.
METHODS: "MAS por Nosotras" adopted a co-creation and co-production approach including a formative phase (focus groups with FSWs and semistructured interviews with stakeholders), and a prospective cohort of FSWs at a non-governmental organization (NGO) in Argentina. Our conceived model focused on HIV treatment and combination prevention, including STI testing, cancer screening, contraception counselling and vaccination. Demographic, psychosocial and clinical information were collected.
RESULTS: Between June 2023 and March 2024, 200 cisgender and transgender FSWs were enrolled in the prospective cohort, with a 66.5% retention rate at 6 months. HIV prevalence was 18.5% (34.3% in transgender women [TGW] and 3% in cisgender women [CGW]), with only one incident case during follow-up. Among those with known HIV, 61% had a viral load <50 copies/mL. PrEP acceptance was higher in TGW (55.6%) versus 30.5% in CGW, but PrEP persistence was low (69% discontinued), especially in CGW. Nearly 78.5% of participants indicated they would be very likely to recommend the care package to their peers.
CONCLUSIONS: "MAS por Nosotras" implemented a community-linked, gender-informed integrated SRH-HIV model of care, articulated with community-based organizations, public health and an NGO research centre that facilitated access to HIV testing, prevention and treatment initiation or re-engagement. We found a high prevalence of HIV, particularly among TGW, and low PrEP knowledge and use, especially among CGW. Our data reflect the need of expanding and tailoring HIV prevention strategies with a community-focused approach. This proposed integrated SRH-HIV model addressed these needs and generated preliminary evidence regarding operational feasibility and acceptability that may inform models to help close prevention and treatment gaps for FSWs in Latin America.
METHODS: "MAS por Nosotras" adopted a co-creation and co-production approach including a formative phase (focus groups with FSWs and semistructured interviews with stakeholders), and a prospective cohort of FSWs at a non-governmental organization (NGO) in Argentina. Our conceived model focused on HIV treatment and combination prevention, including STI testing, cancer screening, contraception counselling and vaccination. Demographic, psychosocial and clinical information were collected.
RESULTS: Between June 2023 and March 2024, 200 cisgender and transgender FSWs were enrolled in the prospective cohort, with a 66.5% retention rate at 6 months. HIV prevalence was 18.5% (34.3% in transgender women [TGW] and 3% in cisgender women [CGW]), with only one incident case during follow-up. Among those with known HIV, 61% had a viral load <50 copies/mL. PrEP acceptance was higher in TGW (55.6%) versus 30.5% in CGW, but PrEP persistence was low (69% discontinued), especially in CGW. Nearly 78.5% of participants indicated they would be very likely to recommend the care package to their peers.
CONCLUSIONS: "MAS por Nosotras" implemented a community-linked, gender-informed integrated SRH-HIV model of care, articulated with community-based organizations, public health and an NGO research centre that facilitated access to HIV testing, prevention and treatment initiation or re-engagement. We found a high prevalence of HIV, particularly among TGW, and low PrEP knowledge and use, especially among CGW. Our data reflect the need of expanding and tailoring HIV prevention strategies with a community-focused approach. This proposed integrated SRH-HIV model addressed these needs and generated preliminary evidence regarding operational feasibility and acceptability that may inform models to help close prevention and treatment gaps for FSWs in Latin America.